At Quartz, we're doing all we can to keep you informed during this pandemic. We have several updates on extended timelines for fully insured commercial members.
Extended timelines on coverage with no out-of-pocket costs
COVID-19 viral testing:
COVID-19 antibody testing:
*Medically necessary tests include tests for members with known or suspected symptoms, known or suspected exposure, and those entering health care facilities for service.
Third-party screening tests for employment, school admission, or travel are not covered
As you can see, we cover tests ordered by a provider to meet members’ medical needs. We do not cover screening tests requested by third parties,
such as those for employment, school admission, or travel:
COVID-19 vaccines are covered 100% with $0 cost-share
Vaccinations and administration costs for COVID-19 are covered with $0 cost-share for all Quartz members. The cost of the COVID-19 vaccine will initially be paid for by the federal government and should not be submitted to Quartz for reimbursement.
See below for guidance on billing for the administration of the COVID-19 vaccinations.
Monoclonal Antibody COVID-19 Infusion
Quartz will not provide payment to providers for the monoclonal antibody products that they receive for free.
Telehealth Visits and Virtual Visits return to usual cost-share January 1, 2021
To help during difficult times, Quartz waived member cost-share for telehealth visits and virtual visits through December 31, 2020. This benefit enhancement ends for most members* with the start of the new year. Members pay their usual out-of-pocket costs beginning January 1, 2021.
*Members on an Illinois-licensed policy have $0 cost-share through the end of the Illinois Disaster Proclamation.
To appropriately apply benefit coverage for your patients, all provider telehealth claims must have at least one of the telehealth modifiers listed below.
All telemedicine claims must have at least one of these indicators:
95 - Telemedicine Service
CR - Catastrophe/Disaster Related
CS - Subject to a cost-sharing waiver for testing-related services for COVID-19
GT - Via Interactive Audio and Video Telecommunication System
GQ - Via Asynchronous Telecommunication System
GO - Telehealth Services for Diagnosis Evaluation or Treatment of Symptoms of an Acute Stroke
Traditional True Telehealth Services
Historically in-person services now provided via telehealth
POS should equal what it would have been for in-person with modifier 95 to indicate provided by telehealth